Healthcare Provider Details

I. General information

NPI: 1457592875
Provider Name (Legal Business Name): DOROTHY HOLLINGSWORTH WEST MA, CAP, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2009
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

649 CHAMBERLIN AVE
FRANKFORT KY
40601-4288
US

IV. Provider business mailing address

9706 RAINBOW LN
PORT RICHEY FL
34668-4166
US

V. Phone/Fax

Practice location:
  • Phone: 813-388-0425
  • Fax: 813-994-0518
Mailing address:
  • Phone: 813-388-0425
  • Fax: 813-994-0518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number241206
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number241206
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number241206
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: